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A client diagnosed with Parkinson's disease is having difficulty adjusting to the disorder. The nurse provides education to the family that focuses on addressing the client's activities of daily living. Which statement indicates that the teaching has been effective?
- A. We should plan for only a few activities during the day.'
- B. We should assist with activities of daily living as much as possible.'
- C. We should cluster activities at the end of the day, to help conserve energy.'
- D. We should encourage and praise efforts to exercise and perform activities of daily living.'
Correct Answer: D
Rationale: The client with Parkinson's disease has a tendency to become withdrawn and depressed, which can be limited by encouraging the client to be an active participant in his or her own care. The family should plan activities intermittently throughout the day to inhibit daytime sleeping and boredom. The family should also give the client encouragement and praise for his or her perseverance in these efforts and help only when necessary.
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The nurse has an established relationship with the family of a client whose death is imminent. Which intervention should the nurse focus on in order to help the family most effectively cope with this experience?
- A. Limiting time in the client's room to promote privacy
- B. Providing education regarding coping mechanisms to use
- C. Identifying spiritual measures that work best for dying clients
- D. Answering questions clearly and providing resources as requested
Correct Answer: D
Rationale: Maintaining effective and open communication among family members affected by death and grief is important to facilitate decision making and effective coping. The nurse maintains and enhances communication and preserves the family's sense of self-direction and control effectively by answering questions clearly and providing information and resources for decision making as requested by the family. Isolating the family from the client by limiting time in the client's room is inappropriate. The nurse should not provide education about coping mechanisms for family members to use because coping mechanisms directed by the nurse are unlikely to be as effective as the methods that the individuals choose for themselves. Identifying spiritual measures that work best for the dying client generalizes and does not reflect individualized care.
The nurse is interacting with the family of a client who is unconscious as a result of a head injury. Which approach should the nurse use to help the family cope with their concerns?
- A. Explain equipment and procedures on an ongoing basis.
- B. Discuss displaying their grief only when not in the room with the client.
- C. Discourage them from touching the client in order to minimize stimulation.
- D. Explain that they need their rest so they should adhere to regular visiting hours.
Correct Answer: A
Rationale: Families often need assistance to cope with the sudden severe illness of a loved one. The nurse should explain all equipment, treatments, and procedures, and he or she should supplement or reinforce the information given by the primary health care provider. Displaying grief is a normal process and should not be discouraged. The family should be encouraged to touch and speak to the client and become involved in the client's care in some way if they are comfortable with doing so. The nurse should allow the family to stay with the client whenever possible. This is important for both the client and the family.
A stillborn baby was delivered a few hours ago. After the birth, the family has remained together, holding and touching the baby. The registered nurse is orienting a new nurse, and has provided education on how to communicate with the family. Which statement by the new nurse indicates that teaching has been effective?
- A. How can I assist you with ways to remember your baby?'
- B. You seem upset. Do you think a tranquilizer would help?'
- C. I feel so bad. I don't understand why this happened either.'
- D. I can allow another 15 minutes together for you to grieve.'
Correct Answer: A
Rationale: Nurses should be able to explore measures that assist the family with creating memories of the infant so that the existence of the child is confirmed, and the parents can complete the grieving process. The correct option identifies this measure and also demonstrates a caring and empathetic client-focused response while providing the family with the option to express their needs. Option 2 devalues the parents' feelings and is inappropriate. Option 3 is inappropriate and reflects a lack of knowledge on the nurse's part. Option 4 appears that the nurse is uncaring.
The nurse is bathing a client when the client begins to cry. Which action by the nurse is therapeutic at this time?
- A. Continue bathing the client and say nothing.
- B. Stop the bath, cover the client, and sit with the client.
- C. Stop the bath, cover the client, and allow the client private time.
- D. Call the primary health care provider to report the signs of depression.
Correct Answer: B
Rationale: If a client begins to cry, the nurse should stay with the client and let the client know that it is all right to cry. The nurse should ask the client what the client is thinking or feeling at the time. By continuing the bath or by leaving the client, the nurse appears to be ignoring the client's feelings. Crying alone is not necessarily an indication of depression, and calling the primary health care provider is a premature action.
When a client is dead on arrival (DOA) to the emergency department, the family states that they do not want an autopsy performed. Which statement should the nurse make in response to the family?
- A. Autopsies are mandatory for clients who are DOA.'
- B. Federal law requires autopsies for clients who are DOA.'
- C. The medical examiner makes the decision about autopsies.'
- D. I will make sure the medical examiner is aware of your request.'
Correct Answer: D
Rationale: The nurse should notify the medical examiner or the coroner when a family wishes to avoid having an autopsy on a deceased family member. Normally the medical examiner will honor the family request unless there is a state law requiring the autopsy. Depending on the state, it is not mandatory for every client who is DOA to have an autopsy. However, many states require an autopsy in specific circumstances, including sudden death, a suspicious death, and death within 24 hours of admission to the hospital. Autopsy is not a requirement under federal law.